An Ounce of Prevention: Pantoprazole in the Intensive Care Unit and Aspirin for Primary Prevention in Diabetes

Christopher Giuliano, clinical pharmacist, is hosting this week’s episode of The Rounds Table with Claudia Hanni, an Internal Medicine clinical pharmacist. Together they are covering pantoprazole for gastrointestinal bleeding in the intensive care unit and aspirin for primary prevention in patients with diabetes.

In the intensive care unit, many patients receive pantoprazole for prevention of gastrointestinal stress ulceration. The risks and benefits of this are unclear. Chris discusses a trial performed to assess patients in the intensive care unit with a high bleeding risk and whether intravenous pantoprazole 40 mg or placebo have an effect on mortality. Other secondary outcomes, such as clinically important gastrointestinal bleeding, were also reported by researchers.

It is known that diabetes mellitus is associated with an increased risk of cardiovascular events. Claudia reviews the ASCEND trial, comparing aspirin to placebo for primary prevention in patients with diabetes with no known cardiovascular disease. The outcomes in terms of bleeding risk are also discussed.

Next, The Good Stuff segment. Chris tells listeners about an article on dietary supplementation and the common reasons for use, and Claudia discusses an article on the major causes of death in children and adolescents in the United States.

For this month’s special segment, Sheliza Halani interviews Dr. James Downar, Head of the Division of Palliative Care for the University of Ottawa, on medical assistance in dying and how this is related to end-of-life care and treatment options.

This document is provided under the terms of a CreativeCommons Attribution Non-commercial Share Alike license. The terms of the license are available at: http://creativecommons.org/licenses/by-nc-sa/3.0/. Attributions are to be made to HealthyDebate.ca, a project under the direction of Dr. Andreas Laupacis, at the Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael’s Hospital.